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Enrollment Periods and Eligibility

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What Are Medicare Enrollment Periods?

If you’re about to become eligible for Medicare, Teton Medicare is here to help walk you through the enrollment process. If you wait until after the initial enrollment period, you may have to pay a penalty and there could be a gap in your health coverage.

See below for the answers to some commonly asked questions about Medicare enrollment, then give us a call to schedule your FREE consultation. Let Teton Medicare put a decade of knowledge and experience to work for your insurance needs.

Medicare Enrollment FAQ

Your initial enrollment period begins three months before the month you turn 65 and ends three months after your birthday month.

The only exception is if your birthday falls on the first of the month, which causes the enrollment period to start one month early.

During the initial enrollment period, you can enroll in Medicare Part A, B, C or D.

  • Once you are enrolled in Medicare Part A and B (Original Medicare), there is a six-month open enrollment period for Medigap (Medicare Supplement) plans. This window begins with your effective date for Part B and is a one-time election period.

If you missed your initial enrollment period, you may face some penalties, but only if you do not have any other credible coverage.

If you do not enroll in Part B during initial enrollment, you’ll pay a late enrollment penalty of an extra 10% of your premium for every 12-month period you should have had Part B. This penalty is added to each month as long as you have coverage. 

If you don’t have Part D coverage and missed your enrollment period, you’ll also pay a late enrollment penalty of an extra 1% of your premium for as long as you have coverage.

If you do not qualify for free Part A coverage for whatever reason and you miss your enrollment period, you may also pay an extra penalty of an extra 10% of your premium for twice the number of years you didn’t have coverage.

Many individuals work beyond the age of 65 and would like to continue their employer coverage, instead of signing up for Medicare. When you do retire, you’ll be able to enroll during a special enrollment period. This period is eight months long and begins either the month after you or your spouse retires or the month your employer-provided coverage ends, whichever happens first. Often times, Medicare plans are less expensive and offer better benefits than employee plans. Request a free consultation today, it’s worth knowing all your options and comparing benefits.

If you work beyond age 65 and have employer-provided coverage you would like to continue with, you can delay enrollment into Medicare without penalty.

If you move outside of a plan’s service area, this triggers a two-month enrollment period during which you could switch to a Medicare Advantage or Part D plan. You could also return to Original Medicare without a penalty and possibly enroll in Medigap.

The annual enrollment period for Medicare Part C and D begins October 15 and ends December 7, respectively, each year.  If you miss this period, you may be required to wait for the next valid enrollment period.

During annual enrollment, you can switch to Medicare Advantage from Original Medicare (Plans A and B). You can also switch your Medicare Advantage plans and Part D plans.

Medicare now provides an additional enrollment period specifically for Medicare Advantage plans. This enrollment period begins January 1st through March 31st and allows you to make a change from one Advantage plan to another. 

Free Consultations

Call today to compare costs of plans, estimate your savings and get help with your enrollment.

“Lee was just what we needed and communicated information we previously had not been able to understand…clearly and concisely…kind and supportive. Looking forward to working with him as we get closer to retirement. So glad we found him…a most valuable resource and a great people person as well. How fortunate to have met him!”

– Jan and Chris M via Google

All About Medicare Eligibility

You can qualify for Medicare coverage at the age of 65 if you are a U.S. citizen or a permanent resident and you have lived in the U.S. continuously for at least five years. If you are under 65, you can also qualify if you meet these criteria: 

  • You are permanently disabled and have been receiving Social Security disability income benefits for 24 months.
  • You have end-stage renal disease.
  • You have Amyotrophic Lateral Sclerosis (ALS aka Lou Gehrig’s disease).
Part A Eligibility
You are eligible for Medicare Part A coverage at no cost at the age of 65 as long as you or your spouse has worked for at least 10 years in the United States. If you have not worked for 10 years, you can still purchase Part A coverage. If you have already enrolled in Social Security, you will be automatically enrolled in Part A. If not, contact the Social Security office to enroll. Your Medicare card will arrive approximately one month before you turn 65-years-old.
Part B Eligibility
The same eligibility requirements for Part A apply for Part B, though there is a monthly premium.
Part C Eligibility
To be eligible for Medicare Part C (aka Medicare Advantage), you must first be enrolled in Medicare Part A and B.
Part D Eligibility
You are eligible for Part D as long as you are enrolled in either Medicare Part A or B.

Are You Required to Sign Up for Medicare?

No, you are not, but if you do not have health insurance already, there will be penalties for delaying your enrollment.

If you have any other questions, Teton Medicare is here to answer them! Fill out our convenient online form to request an appointment. Our independent agency is connected with all competitive providers in the area, so we can give you the best selection of options.

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